ORIGINAL RESEARCH article
Front. Med.
Sec. Pulmonary Medicine
Volume 12 - 2025 | doi: 10.3389/fmed.2025.1650014
The Value of Cough Sound Monitoring via an Audio-Enabled Smartwatch for OSA Screening in COPD Patients: A Cross-Sectional Exploratory Study
Provisionally accepted
- First Hospital, Peking University, Beijing, China
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Objective The purpose of this study is to explore the value of cough sounds and forced exhalation sounds monitored by smartwatches with audio collection capabilities for screening obstructive sleep apnea (OSA) in patients with chronic obstructive pulmonary disease (COPD). Methods Stable COPD patients were recruited from an outpatient clinic. All participants completed questionnaires and underwent pulmonary function testing and overnight polysomnography (PSG). A novel smartwatch capable of collecting audio signals was worn to continuously monitor peripheral oxygen saturation (SpO₂), heart rate (HR), heart rate variability (HRV), and respiratory rate (RR). Additionally, voluntary cough and forced exhalation sounds were recorded twice daily. Audio data were denoised, segmented, and analyzed using time-and frequency-domain features. Correlations between audio features and OSA diagnosis/severity were assessed and a predicting model were developed base on these data. Results Among the 29 participants with stable COPD, 26 underwent PSG, and 17 were diagnosed with comorbid OSA. Multiple cough and forced exhalation subfeatures correlated significantly with OSA diagnosis and apnea and hypopnea index (AHI). Cough sounds showed the highest correlation with OSA diagnosis (r = -0.6629, P < 0.001). A logistic regression model using a cough sound subfeature (the median of MFCC_35) achieved 92% accuracy with a Cohen's kappa value of 0.8276 in predicting OSA in COPD patients. d Conclusion This study demonstrates a strong association between cough sounds and OSA risk in COPD patients. Cough sounds recorded by smartwatches may serve as a valuable tool for screening OSA in COPD patients, contributing to the management of patients with overlap syndrome.
Keywords: Cough sound, SmartWatch, COPD, osa, Audio
Received: 20 Jun 2025; Accepted: 09 Sep 2025.
Copyright: © 2025 Zhang, Zhang, Jin, Yu, Wei, Meng, Jin, Liao and Wang. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Jiping Liao, First Hospital, Peking University, Beijing, China
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